This invention relates to vessel cutting devices for use in the repair, replacement or supplement of a medical patient""s natural body organ structures or tissues. More particularly, this invention relates to vessel cutting devices for use in vascular anastomosis (the surgical connection of vessels).
An example of the possible uses of the invention is a minimally invasive cardiac bypass procedure. This and other examples are considered in detail in Goldsteen et al., U.S. patent application Ser. No. 08/745,618, filed Nov. 7, 1996, which is hereby incorporated by reference herein in its entirety.
Vascular anastomosis is a delicate and time-consuming procedure in which fast and accurate vessel cutting plays a particularly important role.
In view of the foregoing, it would be desirable to provide a catheter-based system for accessing specific body cavities percutaneously, thereby minimizing patient trauma.
It would also be desirable to provide fast and accurate vessel cutting devices.
It is an object of the present invention to provide a catheter-based system for accessing specific body cavities percutaneously, thereby minimizing patient trauma. It is also an object to provide fast and accurate vessel cutting devices.
These and other objects are accomplished by providing a method and apparatus for creating an aperture at an access site in a patient""s existing tubular body organ structure by passing a delivery sheath axially along the interior of a portion of the existing tubular body organ structure to place a distal end of the delivery sheath near the access site, passing a centering wire axially along the interior of the delivery sheath, piercing through from inside to outside of the patient""s existing tubular body organ structure at the access site by causing an end portion of the centering wire to emerge from the distal end of the delivery sheath, passing a cutting catheter substantially coaxially over the centering wire and axially along the interior of the delivery sheath, forming the aperture by advancing a distal end of the cutting catheter through from inside to outside of the patient""s existing tubular body organ structure at the access site and advancing the distal end of the delivery sheath through from inside to outside of the patient""s existing tubular body organ structure at the access site.
In one embodiment, the distal end of the cutting catheter is rotated to cut through the patient""s existing tubular body organ structure at the access site. In another embodiment, a cutting catheter with a conical (preferably star-shaped) cutting edge is pushed through the patient""s existing tubular body organ structure at the access site.
The present invention can also be used to create an aperture in the patient""s existing tubular body organ structure by advancing a distal end of the cutting catheter through from outside to inside of the patient""s existing tubular body organ structure at the access site.
In the most preferred embodiment, all or substantially all necessary apparatus is inserted into the patient via the patient""s existing body organ vessel. In addition, all or substantially all apparatus functions are controlled by the physician (a term used herein to also include supporting technicians) from outside the patient""s body.